Right doctors in right place

Two of the surgeons who were waiting to pick up the pieces from the “mini-mass-casualty” event in Tucson, Ariz., have ties to the Washington area and, some might say, were the right doctors at the right place at the right time to help Rep. Gabrielle Giffords.

Peter Rhee, head of the trauma department at the University of Arizona Medical Center, said he had all the gear and good people he needed Saturday as Giffords and 10 others were brought to the emergency department.

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Friends describe Rhee as “solid,” and he has appeared unflappable during news conferences. Rhee was responsible for triaging the victims as they arrived at UMC Saturday morning.

In 1987, Rhee trained at the Uniformed Services University of the Health Sciences, on the grounds of the National Naval Medical Center in Bethesda, Md., where he now performs experimental combat surgery, according to information on the University of Arizona website. He has served in the wars in Afghanistan and Iraq, where he was highly decorated, and specializes in resuscitation, homeostasis and trauma.

In briefings about the massacre, Rhee said that when the shooting began, there were four trauma surgeons, a pair of neurosurgeons and a vascular surgeon on duty. Thirty-eight minutes later, first responders had Giffords at the emergency department, and the quick timing was crucial to her prognosis, various neurosurgeons and doctors told POLITICO.

Randall Friese was the trauma surgeon who initially assessed Giffords, according to Rhee, and helped stabilize her after transport to UMC. Friese is Rhee’s associate director at the UMC trauma center and graduated from the University of Maryland School of Medicine in Baltimore.

After Giffords was stabilized, Michael Lemole, chief of neurosurgery at UMC and a professor of neurosurgery, took over. He explained his role during briefings Sunday, which included removing bone fragments, dead tissue and foreign objects and detaching the left side of Giffords’s skull.

Rhee said his team worked like a “finely tuned machine,” and he praised Friese.

“He did everything right,” Rhee said, adding that he was able to quickly assess the congresswoman’s condition and order tests to allow Lemole to do his work. Asked by reporters how the situation compares with combat, Rhee was dismissive.

“This doesn’t really compare to combat,” he said.

“I have all the gear and people I could possibly want,” he said with a smile. “This is a luxury for me.”

Rhee told reporters Monday that he had called in two prominent neurosurgeons to consult. Both are colleagues of Rhee’s and served alongside him at the USUHS in Bethesda.

Col. Geoffrey Ling is a neurosurgeon who works for the Defense Advanced Research Projects Agency, in its Defense Sciences Office, and James Ecklund, a retired Army colonel and United States Military Academy graduate, is a renowned neurosurgeon and medical director of neurosciences for Inova Health System.

The two flew to Tucson early Monday. Ling and Ecklund will also talk with family members about the condition of the victims and their prospects for recovery.

A spokesman for the USUHS confirmed that Ecklund was a classmate of Rhee’s and that the two worked closely together and with Ling, who graduated from Georgetown University’s medical school. The three men recently co-authored a paper about the surgical innovations that have arisen from the wars in Afghanistan and Iraq.

The physicians are now collaborating on the treatment of Giffords, whose recovery could be lengthy.

“Neurological time is measured in months and years,” said neurosurgeon Alex Valadka, past chairman of the neurotrauma section of the American Academy of Neurological Surgeons. “There can still be a lot of recovery and rewiring going on in the nervous system years later; and for families, that can be both reassuring and agonizing.”